This is page numbers 4369 - 4400 of the Hansard for the 19th Assembly, 2nd Session. The original version can be accessed on the Legislative Assembly's website or by contacting the Legislative Assembly Library. The word of the day was know.

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Rylund Johnson

Rylund Johnson Yellowknife North

Thank you, Mr. Speaker. When this House first made it a priority to implement the UN Declaration on the Rights of Indigenous Peoples, I think there was varied understandings of what that meant. And how could there not be, Mr. Speaker? It is a very aspirational document with many sections and many different areas to cover.

However, Mr. Speaker, I think all of us meant it would be doing something in this House. And to date, we have not seen any work to actively implement the UN declaration. Some of us thought perhaps we would just pass legislation similar to BC or the federal government which requires an action plan. Perhaps some of us thought we would see an action plan and it would tweak some programs and services and some internal functions of the GNWT. Perhaps some of us thought it would transform the nature of consultation to truly be pre, prior, and informed consent so that the NWT can be the first jurisdiction to take a step beyond endless, sometimes hollow, consultation and require true consent from Indigenous governments.

I think many of us thought it meant we would settle numerous self-government agreements and truly devolve powers like was the promise of devolution. However, Mr. Speaker, more specifically back in the spring, I was informed in this House during Committee of the Whole that there was an internal inventory being created to assess where all GNWT programs aligned or misaligned with the principles of UNDRIP. This inventory was then going to be used to help discussion with the Council of Leaders and eventually lead to an action plan.

Mr. Speaker, I have asked for this action plan or inventory on multiple occasions now, and still have not seen nothing.

Mr. Speaker, when I raise this, it is said that the work is currently being done at the Council of Leaders. The Premier speaks proudly of the work being done at the Council of Leaders yet, Mr. Speaker, if we don't see any of that work and it doesn't result in any meaningful change, it is not something to be proud of.

We presently have 14 negotiating tables, Mr. Speaker, with no real progress. I'm not sure that adding one more to this Assembly is what we meant when we said implementing UNDRIP.

Now, Mr. Speaker, I recognize that we have to work with the Council of Leaders and we have work with Indigenous governments to get something -- to implement UNDRIP. It would defeat the purpose to do it unilaterally; I recognize that. But if we don't get anything done in the life of this Assembly, what is the point of making it a priority for this assembly.

I will have questions for the Premier about realistically what is actually going to be done to implement UNDRIP in the lifetime of this Assembly. Thank you, Mr. Speaker.

The Speaker

The Speaker Frederick Blake Jr.

Thank you, Member for Yellowknife North. Members' statements. Member for Frame Lake.

Kevin O'Reilly

Kevin O'Reilly Frame Lake

Merci, Monsieur le President. It's been almost six months since the signing of the federal territorial agreement promising $10 a day child care for parents across the Northwest Territories. In reviewing the issues of implementation and delivery of benefits, I regret to say that a lot of progress still needs to be made.

The biggest issues remain putting money in the hands of parents who continue to pay for child care after the deal was signed and creating enough spaces to meet demand. The rebate money has to flow through the child care providers to the parents, and that can only happen when providers opt in to the conditions of the program. The deadline for that opting in was April 15, and according to media reports and communication from parents and providers, there are still a lot of questions and uncertainties.

I will be asking the Minister for the status of service providers opting in and how he plans to deal with providers who have not.

A big decision point in whether or not providers opt in is the cap on increasing fees in the future to deal with increased costs. The Minister has confirmed there is a 2.3 percent ceiling or cap on cost increases providers can charge if they opt in, unless special approval is given for a higher increase. Even at the time of signing, we knew Canada was in for a period of inflation, and it's now running at 6.7 per cent nationally, and 7.1 percent in Yellowknife. This agreement handcuffs our operators to increases 4 points below inflation, and I wonder why Cabinet agreed to such a cap.

Then there's the question of creating additional spaces and the allowable use of the agreement funds. For operators, questions remain unanswered on whether funds can be applied to training and staff development, or to wage subsidies for marginally-paid workers. Crucially, can the funds be used to meet the costs of infrastructure that must be built if we are to expand capacity and access? $10 a day child care is meaningless if there are no spots available for care in all our communities. There are at least 10 communities that lack any child care at all, a huge handicap to the development of local economies as well.

I will have questions for the ECE minister on the status of this agreement and its implementation that lie ahead. Mahsi, Mr. Speaker.

The Speaker

The Speaker Frederick Blake Jr.

Thank you, Member for Frame Lake. Members' statements. Member for Nahendeh.

Shane Thompson

Shane Thompson Nahendeh

Thank you, Mr. Speaker. Mr. Speaker, in April, we lost an outstanding son, husband, father, officer, manager, mentor, and friend much too soon.

Adrian Lizotte was born in Fort McMurray on June 20th, 1979. He came to the NWT in 1990, late 1990s, and his appreciation for the beauty of the growth, northern growth. He loved to get out on the land, participate in traditional activities, and spent much of his time hunting, fishing, and camping with friends and family.

Adrian carried that love for the land with him into his work as well. He started his career with the GNWT as a corrections officer and then joined ENR as a fire tech summer student in 2008.

As life took him down the ENR path, he became a renewable officer, finally to manage our wildlife and environment in the North Slave region. He committed 23 years of his life to the GNWT and the people of the Northwest Territories.

Mr. Speaker, Adrian had a pivotal role in the wildfire management programs. I can say he was a natural leader, colleague, mentor, supervisor, and friend to many people who have worked with him. He was well-respected in the community and took pride in work with people sharing his passion for wildlife and keeping people safe.

Adrian received the Premier's award as part of the team that responded to the largest outbreak of anthrax in wood bison in 2012 and was recognized as the ENR Manager of the Year in 2017.

Mr. Speaker, Adrian, just as Adrian served the public at work, he also was a very active member in the community in the evenings and on weekends. Everyone who spent time at the rink in Yellowknife in the last ten years would have been hard pressed to miss Adrian. If he wasn't coaching young hockey or watching his kids play, Boomer was on the ice as an accomplished well-liked and respected player. He was an avid sports fan, and he was always a team player.

As proud as Adrian was of being an officer and a manager at ENR, Mr. Speaker, his real pride and joy was his family. He and his wife Amy met through a friend who introduced them in Yellowknife and quickly fell in love. Together, they had three children - Wesley, Cole, and Sophia, and the centre of their lives. Adrian was a very proud father who would do anything for his kids to be happy and successful, succeed in life.

He instilled in them the same love of the land, tradition, and community that were so important to him. Among of the many contributions Adrian made in his 42 years, there's no doubt he holds raising his children above all.

After his passing, there was a flood of memories and tributes for Adrian from friends, colleagues, and acquaintances from across the NWT and beyond. To paraphrase one of those tributes, may Adrian's kind spirit travel across the land, among the animals he protected over the years.

I'd like to extend my deepest condolences to Amy, their children, and extended family, friends and colleagues, and the countless others he touched over the life. Adrian's passing is a monumental loss for us all. He is and will be missed, Mr. Speaker, and he will always be remembered. Thank you, Mr. Speaker.

The Speaker

The Speaker Frederick Blake Jr.

Thank you, Member for Nahendeh. Our thoughts and prayers are with the family and his fellow colleagues. I know he will be deeply missed, mahsi.

Members' statements. Recognition of visitors in the gallery. Member for Nahendeh.

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Shane Thompson

Shane Thompson Nahendeh

Thank you, Mr. Speaker. Mr. Speaker, there are three officers here that were colleagues of Adrian here. So I'd like to recognize Lee Mandeville, Lorne Hudson, and Daniel Bouvier Junior. Thank you very much for being here today. Thank you.

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The Speaker

The Speaker Frederick Blake Jr.

Thank you, Member for Nahendeh. Recognition of visitors in the gallery. Honourable Premier.

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Caroline Cochrane

Caroline Cochrane Range Lake

Thank you, Mr. Speaker. I'd like to also recognize the officers that are here in respect, but I also want to recognize Lorne Hudson who I believe is a constituent of Range Lake, so. Thank you, Mr. Speaker.

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The Speaker

The Speaker Frederick Blake Jr.

Thank you, Member for Range Lake. Recognition of visitors in the gallery. Member for Yellowknife North.

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Rylund Johnson

Rylund Johnson Yellowknife North

Well, if the Premier's going to do it, I'll do it too. Mr. Speaker, I'd like to recognize a Yellowknife North constituent Lee Mandeville, a friend and colleague of Adrian Lizotte, and one heck of a fiddle player as well, Mr. Speaker.

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The Speaker

The Speaker Frederick Blake Jr.

Recognition of visitors in the gallery.

I too would like to welcome Mr. Lee Mandeville, famous throughout the Northwest Territories for his fiddle playing. I was just thinking oh, it would have been nice to have a good square dance in here one day, but. Welcome to the Chamber. It's always good to have an audience. And also if there's anybody else that we missed, welcome to the gallery. I hope you enjoy our proceedings today. Mahsi.

Recognition of visitors in the gallery. Reports of committees on the review of bills. Reports of standing and special committees. Member for Kam Lake.

Caitlin Cleveland

Caitlin Cleveland Kam Lake

Mr. Speaker, Your Standing Committee on Social Development is pleased to provide its Report on Bill 40, An Act to Amend the Medical Profession Act, and commend it to the House.

Introduction

Bill 40, An Act to Amend the Medical Profession Act, was first introduced by the Department of Health and Social Services on November 25, 2021, and then referred to the Standing Committee on Social Development for review. A plain language summary for Bill 40 was tabled on November 26, 2021.

Bill 40 proposes changes to the Medical Profession Act to:

• Exempt physicians in other provinces and territories providing virtual care to NWT residents from needing an NWT licence when there is a referral from an NWT doctor or nurse practitioner;

• Clarifies a regulation-making power to adapt and adopt standards of practice for the practice of medicine;

• Allows the Minister of Health and Social Services to enter into agreements with other governments or organizations about physician licensing;

• Creates a new category of registration and licensing for physicians practicing virtual care without a referral; and

• Allows registers of physicians to be posted online.

The main changes made in committee include:

1. Removal of the virtual care register; and

2. Requiring the Minister to consult with the Northwest Territories Medical Association before recommending regulations on standards for the practice of medicine.

The committee thanks everyone who took the time to participate in the review and provided us with comments and concerns on Bill 40.

This bill provides a permanent arrangement for virtual healthcare services based on NWT referrals. During the COVID-19 public health emergency, the state of emergency, the Minister of Health and Social Services authorized virtual care through a ministerial directive. In accordance with section 3.3 of the Hospital Insurance and Health and Social Services Administration Act, the Department of Health and Social Services made a temporary agreement with the College of Physicians and Surgeons of Alberta to exempt its members from having to licence in the NWT and to continue to provide services needed in the NWT.

The agreement was renewed by one year and will expire by the end of 2022. This bill provides a more permanent arrangement.

Mr. Speaker, I would like to pass to my colleague for Great Slave further reading of this document. Thank you.

The Speaker

The Speaker Frederick Blake Jr.

Thank you, Member for Kam Lake. Member for Great Slave.

Katrina Nokleby

Katrina Nokleby Great Slave

Thank you, Mr. Speaker. Mr. Speaker,

What We Heard

The committee held a public engagement period from December 22, 2021 to April 31, 2022 and a public hearing on May 16, 2022. Near the end of the committee's review period, the Government of the Northwest Territories Department of Health and Social Services identified issues with Bill 40 that could require substantial amendments. These issues addressed some of the points of contention identified by stakeholders.

At the suggestion of the Minister, the committee sought and received an extension of the review period on March 28, 2022. The committee indicated its willingness to work collaboratively with the Minister of Health and Social Services to improve Bill 40.

When a bill is before a standing committee, it is unusual for the Government of the Northwest Territories to be involved in consultation with stakeholders. However, in this instance, committee took the unusual step of requesting that the Minister of Health and Social Services again consult with key stakeholders on the bill during this extension.

The committee received written submissions from the College of Family Physicians of Canada, the Northwest Territories Medical Association, the Royal College of Physicians and Surgeons of Canada, and the Registered Nurses Association of the NWT and Nunavut, and also heard from the Northwest Territories Medical Association in a public presentation on May 16, 2022.

Submitters expressed two key concerns: The lack of integration of care providers into the NWT medical system if virtual care is permitted without a referral and the role of the government in establishing professional standards of practice.

The committee received additional recommendations on future virtual care access and standards of practice considerations beyond Bill 40.

Virtual Care and Exemption to be Licensed

All submissions welcomed Bill 40 for continuing access to virtual care beyond the COVID-19 pandemic emergency measures. As part of clause 9, this change would add subsection 31.6 and create an exemption to the NWT registration and permit requirements for medical practitioners registered in another jurisdiction and referred to by an NWT medical practitioner or nurse practitioner. The proposed addition of subsection 31.6 was not contentious.

The exemption from licensing based on a referral from NWT practitioners has enabled physicians to practice virtual care during the COVID-19 pandemic. All submitters made it clear that this was a welcomed practice that should continue.

The Canadian Medical Association and the NWT Medical Association supported the proposed exemption to allow physicians licensed elsewhere to provide virtual consultation to NWT residents beyond the current public health emergency given the care originates in a request from an NWT care provider with a referral. The NWT Medical Association pointed out that the referral allows for integrated and coordinated service delivery.

Medical practitioners providing virtual care based on a referral are integrated because they can work within an NWT-wide electronic medical record system. The fact that NWT-wide territorial staff are all employees of the NTHSSA allows coordination of virtual care within and outside of NWT.

The NWT Medical Association considered those aspects of the act that would enable referrals to physicians outside of the NWT an essential element of NWT healthcare and wants to continue this.

The Registered Nurses Association of the NWT and Nunavut, and the Royal College of Physicians and Surgeons of Canada, welcomed the exemption. Both submitters explain that the exemption would remove barriers to accessing safe and quality care for the NWT residents and leveraging virtual care as a complement to accessing in-person healthcare and services.

Virtual Care Register

Most respondents expressed strong concerns about the proposed creation of a virtual care register. Bill 40 proposed creating a new 12-month registration and licensing requirement for physicians practicing in other jurisdictions and in good standing with the Canadian Medical Protective Association to provide virtual care in the NWT (section 31, 81).

The registry would allow out of territory health practitioners to practice virtual care to NWT residents without a referral from an NWT health practitioner. This scenario raised several concerns in the medical profession.

Submitters were concerned that allowing practitioners to see patients without a referral may create a parallel system and leave doctors unable to integrate into the NWT medical system by not having access to NWT pharmacies. The NWT Medical Association expressed that the register would not be necessary and potentially harmful to patient care quality and cultural safety in the NWT.

The Canadian Medical Association saw concerns with continuity of care due to the fragmentation between in-person and virtual patient and physician relationships. Challenges with tests and diagnostics would potentially increase demand in hospital emergency departments. Equity concerns would arise, considering potential private pay options in virtual care services.

To address the lack of integration with NWT systems, the College of Family Physicians of Canada asked to include in the virtual register requirements for physicians. Physicians would need to have the ability to ensure informational continuity so that medical records are available and complete, have established connections with an in-person point of care in the NWT, not be affiliated with for-profit paid-access solutions, and have experience and appreciation for the uniqueness of the NWT's regions.

Concerned with continuity of care, the Registered Nurses Association for the NWT and Nunavut advocated for physicians practicing virtual care to understand the role nurses have in communities and healthcare in the North. This would recognize that the proposed amendments would affect the practice of registered nurses and nurse practitioners who work closely with the residents in the NWT.

Mr. Speaker, I'd like to now pass this over to the Member for the Deh Cho. Thank you.

The Speaker

The Speaker Frederick Blake Jr.

Thank you, Member for Great Slave. Member for Deh Cho.

Ronald Bonnetrouge

Ronald Bonnetrouge Deh Cho

Mahsi, Mr. Speaker.

Standards of Practice

Bill 40 proposes adapting standards for the practice of medicine by adding a code of ethics and competency programming. The new paragraph would allow the Minister to recommend regulations on code of ethics, continuing competency programs and the nature of those programs, and scope of practice frameworks and guidelines. The medical community responded with concerns that in most provinces, licensing colleges set and enforce standards of practice within the framework of self-regulation of the medical profession physicians.

The NWT Medical Association pointed out that the profession's priorities may not always align with the priorities of the government. The College of Family Physicians of Canada recommended aligning the application of standards with comparable structures in neighbouring provinces and suggested Alberta is the best fit due to proximity and existing integration.

The College recommended considering an affiliation with an existing licensing College for ease of operation. The Royal College of Physicians and Surgeons of Canada encouraged the NWT government to collaborate with the Federation of Medical Regulatory Authorities of Canada and its regional authorities to ensure pan-Canadian alignment in professional standards of practice.

The Registered Nurses Association of NWT and Nunavut welcomed the new paragraph as it would lead to "increased patient safety and satisfaction by ensuring that virtual practice physicians clearly understand the context of virtual practice in the North."

Gaps to be Addressed in Legislation

The College of Family Physicians of Canada noted that the amendments proposed in Bill 40 do not address issues the Physician Executive sees with the current MPA. These include the reliance on outdated certification requirements, the differential and discriminatory treatment of family physicians compared to other specialists, the inability to administer conditional licenses, etc.

The College recommended consultation with the local physician leadership from the Territorial Physician Executive to understand these requirements.

Future Collaboration Toward Virtual Care Access The Royal College of Physicians and Surgeons of Canada encouraged the NWT government to ensure pan-Canadian alignment in professional standards of practice in Canada. It recommended actions toward virtual care access and standards of practice beyond Bill 40:

1. Leverage virtual care models in an ecosystem that promotes continuity of care (ensure availability of information in the NWT Electronic Medical Record);

2. Provide virtual care within NWT's publicly insured system, which meets the principles of the Canada Health Act;

3. Provide all people living in NWT, including those in rural and remote communities, access to reliable high-speed internet to ensure they reap the full benefits of virtual care;.

4. Design virtual care services in genuine partnership with Indigenous communities of the NWT to ensure care is delivered in a culturally safe manner;

5. Collaborate with people with lived experience (including patients and care partners) to ensure that the virtual care model meets the needs of the people relying on it;

6. Pursue ongoing quality improvement to assure NWT's successful deployment of virtual care;.

7. Integrate virtual care services with in-person care. Consider physician workforce, medical facilities, specialized equipment, clinical teams and other necessary resources, to ensure a proper balance of in-person and virtual specialty care within the territory.

Mr. Speaker, I now turn it over to Member from Inuvik Twin Lakes. Mahsi.

The Speaker

The Speaker Frederick Blake Jr.

Thank you, Member for Deh Cho. Member for Inuvik Twin Lakes.

Lesa Semmler

Lesa Semmler Inuvik Twin Lakes

Thank you, Mr. Speaker.

Committee Considerations

The committee considered several motions that would improve Bill 40, including removing the virtual care register, and adding a requirement to consult with the medical professional community before proposing regulations concerning standards of practice.

Virtual Care and Exemption to be Licensed in the NWT

Committee members noted the strong endorsement of an exception to registration to continue virtual care with referral and to allow the Minister to enter into agreements that would exempt care practitioners from licensing in the NWT and permit them to provide virtual care services to NWT residents. To this effect, subsections 31.6 and 31.7 of clause 9 were maintained.

Virtual Care Register

The committee took into consideration the risks and concerns expressed in the submission. It was noted that the proposed virtual care register would not apply to every situation to prevent unlicensed physicians from practicing in the NWT, not ensure continuity of care or connection in the NWT system, not entirely remove the administrative burden; and, may create a sense of oversight not truly reflective of the situation.

Committee put forward Motions 2, 3, 4, 9, 12 to 19, and 23 to remove the virtual care register from Bill 40.

Standards of Practice and Professional Self-Regulation

Bill 40 proposed establishing or adopting standards of practice, codes of ethics, continuing competency programs, and the nature of those programs, and scope of practice frameworks and guidelines.

The committee observed that the Health and Social Services Professions Act uses the exact wording to give Cabinet the power to make regulations to establish standards of practice, codes of ethics, and competency programs and guidelines.

After hearing from various medical organizations about the potential for the Minister to infringe on the independence of the medical profession through this clause, the committee deliberated whether the concern was the regulation-making power or the standards themselves.

The committee recognizes the position of the professions that creating regulations on standards of practice may infringe on the independence of the medical profession. In connection with those concerns, committee members heard that the concern is not at the level of the standards themselves but that should the Minister choose the standards, it could mean competing interests because the Minister's interest may not be in line with patients' interests.

In conversations with the committee, the Department of Health and Social Services expressed the commitment to consult the medical profession on standards of practice adapted from the College of Physicians and Surgeons of Alberta to bring standards into force in late 2022. The Department plans to include consultations on adopting the Canadian Medical Association's Code of Ethics and Professionalism.

The current legislation allows the Minister to develop regulations respecting standards for the practice of medicine. Therefore, Bill 40 does not contemplate removing or adding the power that the Minister already has. Therefore, removing this power would not be within the scope of Bill 40. The committee considered all comments on self-regulation out of scope but looked to other ways to ensure collaboration as noted in the next section.

The Requirement to Consult before Proposing Regulations

The committee proposed that the Minister should consult with the NWT Medical Association before recommending making regulations regarding establishing or adopting standards of practice, codes of ethics, continuing competency programs and the nature of those programs, and scope of practice frameworks and guidelines under clause 24 para 94.

Committee pursued an amendment with Motion No. 10 allowing the Commissioner to make the stipulated regulations only after consultation with the Northwest Territories Medical Association.

Mr. Speaker, I will now ask to pass it on to my colleague, Member for Monfwi. Thank you.

The Speaker

The Speaker Frederick Blake Jr.

Thank you, Member for Inuvik Twin Lakes. Member for Monfwi.

Jane Weyallon Armstrong

Jane Weyallon Armstrong Monfwi

Thank you.

Several concerns from witnesses were about aspects of virtual care or professional regulations that the committee did not consider in scope with Bill 40. However, the committee found the recommendations relevant to creating a supportive environment for the legislative changes to be successful.

Standards of Practice

The NWT Medical Association requested the NWT government consider the alternate process by contracting organizations such as College of Physicians to develop the standards of practice for physicians. The committee recognizes the position of the professions and accordingly makes the following recommendation.

Recommendation 1: The Standing Committee on Social Development recommends that the Minister engage the services of an independent body, such as other Colleges of Physicians, to develop standards of practice for physicians practicing in the NWT

Ensuring Meaningful Participation

The committee noted that while meaningful participation by physicians in discussions of standards for physicians is desirable and necessary, the NWT reality is that physicians are often working at maximum levels of their capacities with little time left for extensive consultation. Accordingly, the committee makes the following recommendation.

Recommendation 2: The Standing Committee on Social Development recommends that the GNWT work with the NWT Medical Association to ensure they have the ability to meaningfully participate when they are consulted on any proposed standards for physicians in the NWT.

Understanding Certification Requirements.

The committee considered further comments by the College of Family Physicians of Canada on the Medical Professions Act. The College notes problems with the current legislation, the reliance on outdated certification requirements, differential and discriminatory treatment of family physicians compared to other specialists, and the inability to administer conditional licenses as current gaps not addressed by legislative improvements. The College states that "consultation with the local physician leadership from the Territorial Physician Executive would be beneficial in gaining further understanding" of these requirements. Further, committee makes the following recommendation.

Recommendation 3: The Standing Committee on Social Development recommends the Department of Health and Social Services consult with the local physician leadership from the Territorial Physician Executive to understand certification requirements, differential treatment of family physicians compared to other specialists, and the administration of conditional licenses.

Recommendation 4: The Standing Committee on Social Development recommends that the GNWT provide a response to the recommendations contained in this report within 120 days.

I'll now pass it on to MLA Caitlin Cleveland, MLA from Kam Lake. Thank you.

The Speaker

The Speaker Frederick Blake Jr.

Thank you, Member for Monfwi. Member for Kam Lake.

Caitlin Cleveland

Caitlin Cleveland Kam Lake

Thank you, Mr. Speaker. I respond to all of the above.

Clause-by-Clause Review.

The clause-by-clause review of Bill 40 was held on March 19, 2022. At this review, committee moved ten motions. The Minister concurred with all ten motions.

Conclusion

This concludes the Standing Committee on Social Development's review of Bill 40. The committee thanks the medical profession and the public for their participation in the review process, the Department of Health and Social Services for the collaborative effort to improve the proposed changes, and everyone involved in reviewing this bill for their assistance and input.

Following the clause-by-clause review, a motion was carried to report Bill 40: An Act to Amend the Medical Profession Act, as amended and reprinted, as ready for consideration in the Committee of the Whole. This concludes the Standing Committee's review. Thank you, Mr. Speaker.

The Speaker

The Speaker Frederick Blake Jr.

Thank you, Member for Kam Lake. Reports of standing and special committees. Member for Kam Lake.

Caitlin Cleveland

Caitlin Cleveland Kam Lake

Thank you, Mr. Speaker. Mr. Speaker, I move, seconded by the Member for Great Slave, that Committee Report 31-19 (2), Standing Committee on Social Development Report on Bill 40, An Act to Amend the Medical Professions Act, be received by the Assembly and referred to Committee of the Whole. Thank you, Mr. Speaker.